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Biomedical subjects

R Mackie

Publications and source records attributed to R Mackie.

At least 19 recordsLinked to original sources

Screening for skin cancer.

Holidays in sunny climates are taking their toll on British skins. Professor Rona Mackie warns that 'flash frying' attitudes to sun bathing can precipitate skin cancer.

Health Education

Use of external shock-wave lithotripsy and adjuvant ursodiol for treatment of radiolucent gallstones. A national multicenter study.

A prospective multicenter trial was performed to evaluate the use of external shockwave lithotripsy (ESL) and adjuvant medical therapy for the treatment of gallstones. A Medstone STS lithotripter was used together with ursodiol. Two hundred twenty-three patients were treated under general anesthesia (75%) or with intravenous analgesia (25%). Initial treatments were on an inpatient basis, but as centers gained experience, outpatient treatments became more common. Stone fragmentation and clearance were greatest in patients with solitary gallstones less than 2 cm in diameter. In this group of patients, stone fragmentation occurred in 97% of patients, and the cumulative stone-free rates at three and six months were 54% and 90%, respectively. These results indicate that fragmentation of gallstones can be achieved by a dry shock-wave lithotripter and that stone clearance is induced more rapidly by external shock-wave lithotripsy and adjuvant ursodiol therapy than by ursodiol therapy alone.

Adult

Phase II studies of mitozolomide in melanoma, lung and ovarian cancer.

Seventy-seven patients were treated with oral mitozolomide to assess the activity of this drug in melanoma, lung and ovarian cancer. Partial responses were seen in five of 18 evaluable patients with small cell lung cancer (SCLC) and three of 20 with melanoma. No activity was apparent in non small cell lung or epithelial ovarian cancer. The major toxicity was myelosuppression which necessitated reduction in the initial dosage from 115 to 90 mg/m2. However, even at this dose level, unpredictable WHO grade 4 toxicity occurred in non-pretreated patients. Thrombocytopenia was more common than leucopenia and eight patients required platelet transfusion for spontaneous or tumour-related haemorrhage. Myelotoxicity was considered responsible for two deaths and was a significant contributory factor in a further three. Non-haematological toxicity was minor. Thus, despite demonstrable activity in SCLC and melanoma, unpredictable myelosuppression is likely to preclude further assessment in combination chemotherapy regimes in these tumours.

Adult

Staphylococcal colonization in atopic dermatitis and the effect of topical mupirocin therapy.

Forty-nine patients with atopic dermatitis entered a double blind placebo controlled cross-over study of mupirocin, a new topical antistaphylococcal antibiotic. Forty-five patients were evaluable. Quantitative bacteriological assessment before treatment showed that heavy colonization of the skin with Staphylococcus aureus was present in nearly all patients even in the absence of overt infection. However, the bacterial count was significantly reduced by 2 weeks' treatment with topical mupirocin, but not by the placebo. Moreover, a significant reduction of clinical severity was also observed after treatment with mupirocin, which was maintained over the following 4 weeks, although recolonization occurred during this period, with bacterial counts rising to pre-treatment levels. Despite recolonization, clinical deterioration was not observed during the trial period. No serious side-effects were observed. Phage typing showed that 50% of patients carried more than one bacterial phage type. Recolonization in eight patients (17%) was with a 'new' strain that had not previously been isolated.

Administration, Topical

A prospective study of the histological changes in the skin in patients receiving bone marrow transplants.

Fourteen patients who received a bone marrow transplant (BMT) as treatment for leukaemia were included in a prospective study of the histological changes in the skin. The aim of this study was to improve the early diagnosis of graft-versus-host disease (GVHD). It was found that the clinically 'normal' pre-transplant skin was in some cases histologically abnormal on H & E examination in patients who were on regular maintenance cytotoxic chemotherapy. These changes were similar to some of the features of GVHD. Immunocytochemistry, although not specific, was found to be helpful in the diagnosis of some cases of GVHD. Suggestive features included a reduction in the numbers of Langerhans cells, an increase in the number of suppressor (OKT8+) cells in the dermal infiltrate and the presence of Ia positivity of the keratinocytes in the epidermis.

Adult

Muscular hypertonia: quantitative analysis.

By a statistical method of analysis, the force applied to move a limb passively can be translated into physiologically relevant parameters relating to the muscle. The parameters identified and measured are the dynamic and static activity of the muscle and their interactions with the varying length of the muscle during stretch. This method of analysis has been shown to be of assistance in evaluating the reflex status of persons with central nervous system disorders in preparation for treatment and in measuring the effects of treatment.

Humans

Cellular fine structure in the invasive nodules of different histogenetic types of malignant melanoma.

Ultrastructural studies were carried out on the invasive nodule of forty malignant melanomas. The findings support the concept that the fine structure of lentigo maligna melanoma is often characteristic, and differs from that of superficial spreading and nodular melanoma. The melanosomes in lentigo maligna melanoma are usually ellipsoidal and resemble those of normal melanocytes, whereas the melanosomes in superficial spreading and nodular melanoma are most often spheroidal and abnormal in appearance. Superficial spreading and nodular melanomas cannot be distinguished reliably by their ultrastructure. Melanosomal appearances could not be related to the presence of a pre-existing naevus or the depth of invasion of the tumour nodule.

Humans

DNA repair deficiency in lymphocytes from patients with actinic keratosis.

DNA repair activity was measured in peripheral blood lymphocytes from 18 patients with Actinic Keratosis and 18 age-matched control subjects, by comparing the incorporation of 3H-thymidine into cells after irradiation with ultraviolet light with that into unirradiated cells. The incorporation was followed autoradiographically or by measuring acid insoluble radioactivity in cells labelled in the presence of hydroxyurea. The repair activity in lymphocytes from Actinic keratosis patients was only 47.1 percent (+/- 6.5%) of that in cells from the control subjects.

Aged

Distribution of HLA antigens in patients with mycosis fungoides.

19 patients with plaque-style mycosis fungoides have undergone determination of HLA antigen distribution. Deviations from the expected distribution frequency occurred with the antigens of the W19 group comprising A29, W30, W31 and W32 and of B8 and A1. The W19 group deviation was statistically significant (chi2 = 9.7 p value less than 0.005). The significance of this observation in relation to reported immunological abnormalities in mycosis fungoides is discussed.

Adult

Chronic mucocutaneous candidiasis treated with transfer factor.

A patient with chronic mucocutaneous candidiasis resistant to all tropical therapy has had extensive tests of immunological function carried out before and after administration of transfer factor. Immunological testing has been both specific, directed at responses to candida antigen, and non-specific, directed at general assessment of the patient's immune status. Transfer factor has been administered on three occasions in the past year. After each treatment temporary clinical improvement accompanied by changes in both specific and non-specific immunological responses have been observed. The possible mode of action of transfer factor in this case is discussed.

Adult

Lock-ring for Tenckhoff catheter/titanium adaptor junction.

One standard continuous ambulatory peritoneal dialysis (CAPD) infusion/drainage system was found prone to recurrent mechanical failure at the junction between the silastic catheter and the titanium connector. This resulted in slackening and eventual disconnection with attendant risk of bacterial entry and a CAPD-associated peritonitis. A simple "lock-ring" device, when fitted over the catheter-titanium connector junction, afforded a secure joint.

Equipment Failure